OBJECTIVE: To explore whether or not gender predicts consultant activity rates. DESIGN: Using data from the Hospital Episode Statistics for England 2004/2005, we explored inpatient activity rates of male and female hospital consultants, with and without adjustment for case-mix differences. As a sensitivity analysis we also explored outpatient attendances for male and female hospital consultants. SETTING: Data from the Hospital Episode Statistics for England. MAIN OUTCOME MEASURES: Finished consultant episodes per year, with and without adjustment for case-mix differences, age and gender of consultant, contract held, hospital trust, specialty of practice, and clinical excellence awards, discretionary points and distinction awards. RESULTS: Including only consultants on full-time or maximum part-time contracts, men have significantly higher activity rates than women, after accounting for age, specialty and hospital trust. CONCLUSIONS: The reasons for the different activity rates of male and female consultants are unclear, but the implications of these results for the planning of the medical workforce are important.